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Vol. 19. Núm. 6.
Páginas 324-328 (noviembre - diciembre 2012)
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Vol. 19. Núm. 6.
Páginas 324-328 (noviembre - diciembre 2012)
Open Access
Trombosis de vena cava superior asociada a catéter en paciente crítico: Reporte de un caso y breve revisión de la literatura
Superior vena cava thrombosis associated with catheter in critical patients: a case report and brief literature review
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3830
Ricardo Bohórquez1,3, Ángel A. García1,3, David Santacruz1,3,
Autor para correspondencia
, José F. Zuluaga1,2,3
1 Hospital Universitario San Ignacio. Bogotá
2 Universidad de Caldas. Manizales
3 Unidad de Cardiología, Hospital Universitario San Ignacio. Bogotá, Colombia
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Los fenómenos de hipercoagulabilidad son comunes en los pacientes politraumatizados críticamente enfermos. Los principales factores de riesgo para esta complicación son la cirugía, las invasiones vasculares, la inmovilidad y los procesos inflamatorios.

Los catéteres intravasculares proveen un acceso necesario para la administración de terapia intravenosa, toma de muestras sanguíneas y monitorización. Sin embargo, su uso se asocia frecuentemente con complicaciones locales y sistémicas serias incluyendo infecciones diseminadas, tromboflebitis séptica y endocarditis.

En este contexto, debe sospecharse de tromboflebitis séptica de la vena cava superior en el paciente con bacteriemia persistente después de 72 horas de terapia antimicrobiana apropiada.

La base del tratamiento incluye: remoción del foco infeccioso, administración temprana de antibióticos intravenosos y anticoagulación. Así mismo, debe considerarse el tratamiento quirúrgico en aquellos con evolución inadecuada.

Palabras clave:
trombosis
venas
inflamación
infección

Hypercoagulability phenomena are common in critically ill polytraumatized patients. The main risk factors for this complication are surgery, vascular invasions, immobility and inflammatory processes.

Intravascular catheters provide a necessary access for the administration of intravenous therapy, blood sampling and monitoring. However, their use is frequently associated with serious local and systemic complications including disseminated infections, septic thrombophlebitis and endocarditis.

In this context, septic thrombophlebitis of the superior vena cava should be suspected in patients with persistent bacteremia after 72 hours of appropriate antimicrobial therapy.

The mainstay of treatment includes the removal of the source of infection, early administration of intravenous antibiotics and anticoagulation. Also, surgical treatment should be considered in those with inadequate clinical evolution.

Keywords:
thrombosis
veins
swelling
infection
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Copyright © 2012. Sociedad Colombiana de Cardiología y Cirugía Cardiovascular
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